Times of India
17 January 2009
Shobha John
New Delhi, India

It’s like a guided missile with beneficial spinoffs for cancer patients. A relatively new radiation treatment, Image Guided Radiotherapy (IGRT), can now pinpoint the exact location of cancer and direct radiation towards it, improving survival rates. Most tumours move, either due to digestion, elimination or breathing, leading to radiation getting diffused and damaging surrounding tissues.

IGRT was introduced in India in 2007 and is used for cancers where movement is expected: lung, breast and liver (breathing motion), stomach and prostate (filling) and brain (neck movement). Conventional radiotherapy is used in limited doses when there are critical organs like eyes, brain, heart, lungs and spinal cord near the affected area.

Anita Gupta, a doctor in a private hospital here, was diagnosed with cancer of the kidney in 2003. The kidney was removed and chemotherapy done. However, in 2008, it had spread to the lungs and surgery done to remove a part of it. It still didn’t stop the march of this deadly illness as a lesion was found in one lung.

{jumi usermod/ads/ads.php}{/jumi} After weighing many options, Gupta underwent IGRT sessions in October and found it effective. “The lesion has disappeared and my severe breathlessness and cough have gone too. I am now back at work,” she said.

There are three hospitals in India offering IGRT – AIIMS, Artemis Health Institute, Gurgaon and Indo American Hospital in Hyderabad.

“While normal radiation damages surrounding tissues, in IGRT there is minimal damage,” says Tejinder Kataria, head, Radiation Oncology, Artemis Health Institute, Gurgaon. “Normal radiation for lung cancer can damage the food pipe leading to difficulty in swallowing, so that the patient will have to be put on a liquid diet within four weeks. Or take prostrate cancer where the tumour can move upto 2cm and radiation can damage the surrounding urinary bladder, rectum, pelvic bone and intestines, leading to urinary and rectal bleeding.”

P K Julka, professor of oncology at AIIMS, says IGRT is like a missile that is bang on target. “The patient is put on a vacuum mattress and an immobilisation shell to reduce movement. The tumour is imaged by a virtual CT–scan which is there in the machine and the exact dosage decided.”

IGRI is however more expensive than conventional radiation. If the latter costs Rs 70,000 (for 30–35 sittings), in IGRT, it would cost Rs 2.1 lakh, says Kataria. But Gupta says the money spent is worth it. “You live only once. IGRT can prolong your life and improve its quality.”